To determine if the quality of otolaryngology-related journal articles correlates with traditional measures of article impact.
All articles published by Laryngoscope in 2011 were categorized according to level of evidence (LOE) according to the Oxford Center for Evidence Based Medicine rubric. Articles without a level of evidence assigned were alphabetically subcategorized type with letters A-D corresponding to Contemporary Reports, Case Reports, Basic Science or Animal Studies, and Other respectively. Citations per article were then recorded per article each year from 2012 to 2018.
A total of 494 articles were included for analysis, 315 had numerical LOE and 179 had alphabetical LOE. There was a strong negative correlation between numerical LOE and median and interquartile number of citations (= -.9014, = .037). Overall, numerical LOE had a significantly higher median number of citations per article compared with the non-number/alphabetical group (14 vs 6, ?&lt;?.001).
Higher quality research as determined by level of evidence is in fact being cited more frequently than lower quality articles. Although the scope of this study was relatively limited, these data suggest that better designed studies may exhibit greater impact by traditional measures. Such findings should serve as an impetus for (and validation of) continued pursuit of high LOE research.
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NA.To evaluate changes in emergency department and inpatient consult volumes of an otolaryngology service at an academic medical center from 2014 to 2018.
A retrospective review of all otolaryngology consults in the electronic medical record from March 2014 through December 2018 was completed. The total number of consults was recorded to determine changes in consult volume over time. Additional parameters were analyzed including volume of weekday, night and weekend, adult, pediatric, emergency department, and inpatient consults.
From 1 March 2014 to 31 December 2018, a total of 8806 consults were seen by the otolaryngology service. In the first year, a total of 990 consults were seen. In the final year of the time period, a total of 2416 consults were seen. This represents a 144% increase in consults over the examined time period. Similar increasing trends were seen when consults were analyzed by weekday, night/weekend, pediatric, adult, emergency department, and inpatient consults.
This is one of the first studies examining trends in otolaryngology consult volumes at an academic medical center in the United?States. Our data show that the volume of consults has increased by 144% in a 4-year time period, predominantly due to an increase in emergency department consultations. This study demonstrates the increasing burden of emergency department consultations on an otolaryngology service at an academic medical center and highlights a potential role for increasing and improving provider availability.
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4.Determine if chronic rhinosinusitis (CRS) is associated with systemic hypoxemia.
Outpatient otolaryngology visits for 12?months were analyzed, identifying patients with a diagnosis of CRS, without a comorbid diagnosis of pulmonary disease, and an oxygen saturation measurement within 14?days of the otolaryngology visit. Oxygen saturation (SpO) measures (average SpO, minimum SpOand proportion abnormal SpO) were compared between CRS patients (with nasal polyps [NP] and without NP) and a control cohort of otology patients, also without pulmonary disease with univariate and multivariate analysis.
Among 640 unique CRS patients with 3105 encounters, the mean and minimum SpOmeasurements were 97.6% (97.5%-97.7%) and 97.3% (97.2%-97.5%), respectively. Among 3613 control patients with 25?073 encounters, the mean and minimum SpOmeasurements were 97.3% (97.3%-97.4%) and 97.1% (97.1%-97.2%), respectively. When comparing mean and minimum SpOamong CRSsNP (97.5% and 97.2%), CRScNP (97.3% and 97.0%) and control patients (97.3% and 97.1%), no statistically significant differences were found among the 3 groups in mean and minimum SpOadjusting for age and sex (= .183 and = .464, respectively, ANOVA). With respect to the presence of an abnormally low oxygen saturation (SpO???94%), 4.4% of the CRSsNP, 10.9% of the CRScNP and 7.3% of the control patients demonstrated a low oxygen saturation (= .013).
CRS alone does not objectively contribute to systemic hypoxemia, although a subset of CRScNP patients may have abnormally low SpO, possibly warranting SpOassessment in this group of patients.
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3.Frontal sinus surgery is considered one of the more challenging aspects of Functional Endoscopic Sinus Surgery, due to the complex variations in normal sinus anatomy but also increased morbidity due to the close proximity of critical structures such as the anterior cranial fossa and orbits. We aim to investigate the medial canthal point (MCP) as an anatomical landmark for safe frontal sinus access.
The MCP intranasally is identified during surgery with non-tooth forceps, with one limb just anterior to the medial canthus and the other intranasally in the same coronal plane along the skull base. This point was identified on 100 paranasal sinus computed tomography (CT) scan reconstructions. The distance between the anterior cranial fossa and MCP was measured on imaging-medial canthal point distance (MCPD). The maximal anterior-posterior (AP) distance was measured on all scans.
The average MCPD for males was 13.0?mm (8.7-20.4?mm) and for females 12.0?mm (6.8-22.8?mm). Mean AP distance for males was 12.0?mm (4.5-20.2?mm) and for females 10.4?mm (3.8-15.9?mm). https://www.selleckchem.com/products/c-178.html Mean distance for all 100 patients was 12.6?mm (range 7.5-22.8?mm). In all cases, the MCP was anterior to the cranial fossa. Mixed effects modelling analysis showed a significant correlation between the MCPD and AP distance (= .006).
The MCP is a consistent anatomical landmark that can serve as an adjunct to safe frontal sinus access alongside the first olfactory fiber and CT navigation systems. However, patient selection continues to be very important, with larger well pneumatized frontal sinuses being ideal to tackle earlier in a surgeon's career.
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